Tobacco Cessation Clinical Workflow
Screen for tobacco use with every patient, every visit (done by the Medical Assistant or Provider). This is an approach designed to facilitate the routine assessment of tobacco use status among all patients.
- Ask – about tobacco product use
- Advise – about the benefits of quitting and the support available
- Connect– people that are interested in quitting, cessation counseling, and medication support
If the patient consents to a referral for cessation support counseling, you can follow these steps below. Healthcare providers can enhance communication, promote timely sharing of information, and ensure the referring provider receives the results of the referral order, leading to improved coordination and continuity of care:
- Send an electronic referral (if technologically available). Consolidated-Clinical Data Architecture (CCDA) is used to create documents and standardize the content and structure for clinical care summaries. CCDA files are a means to securely transfer medical records between EHR systems. (Fax from the EHR if electronic transmission of the CCDA via direct secure messaging is not yet available)
- Provide the patient a prescription for medication support (If needed).
- Ensure that the provider ordering the referral receives the results of the referral order (Closing the Referral Loop). Closing the referral loop, which ensures that the provider ordering the referral receives the results, is crucial for effective communication and continuity of care.
- When making the referral, ensure that all necessary details are included, such as the reason for referral, specific tests or consultations requested, and any relevant patient information. Clear and concise instructions will help the receiving provider understand the purpose of the referral.
- Depending on the healthcare system and available resources, referrals can be sent electronically through the EHR systems, via secure messaging, or through traditional methods like Fax.
- Follow up with the receiving provider's office to ensure they have received the referral request. This can be done through a secure messaging system or a phone call. Document the confirmation for future reference.
- Implement a system to track the referral from initiation to completion. This could include assigning a unique identifier or tracking number to the referral and updating its status at each stage (Sent, Received, Appointment scheduled, results obtained, etc.)
- If the referral requires prompt attention or has a specific timeline, communicate this information to the receiving provider. It helps prioritize the referral and ensures timely follow-up. Along with the referral, specify expectation for receiving the results. Include a request for the receiving provider to send results back to the referring provider within a specified timeframe.
- Regularly review the status of pending referrals to identify any delays or outstanding results. If there are any delays, reach out to the receiving providers office to inquire. Once the referral results are received, promptly review them to ensure info is complete and accurate.
- After reviewing the referral results, communicate findings to the patient. Provide necessary explanations, recommendations, and next steps required. This ensures the patient is informed and involved in their care.
- Maintain a record of the referral process, including the referral request, confirmation of receipt, any communication with the receiving provider, and the final results. This documentation helps in maintaining a comprehensive medical record and facilitates future reference if needed.
- Follow up on progress with the patient on subsequent visit(s).
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